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- Klinische proef NCT07767851
Two Modalities of Ventilation on the Occurrence of Respiratory Complications During Inhalational Anaesthetic Induction in Children (PEDIAMOVE)
Comparison of Two MOdalities of VEntilation on the Occurrence of Respiratory Complications During Inhalational Anaesthetic Induction in Children: a Multicentre Randomised Controlled Trial.
Induction of anesthesia by inhalation is the most common method of induction (70% in France) for young children admitted for non-emergency surgery. It has the advantage of not requiring an intravenous line.
Serious respiratory adverse events such as laryngospasm or bronchospasm remain common in young children during anesthesia induction (approximately 4%) and can reach up to 30% when mild respiratory adverse events (coughing, desaturation < 95%, airway obstruction) are included.
Traditionally, inhalation induction is performed under spontaneous ventilation using the anesthesia ventilator circuit. However, modern ventilators offer the option of applying positive end-expiratory pressure (PEEP) and pressure support ventilation (PSV). Several physiological studies suggest that the use of PEEP + PSV during anesthesia may help maintain airway patency, minute ventilation, and functional residual capacity (FRC).
Our hypothesis is that administering PEEP + PSV at the time of induction may reduce the risk of respiratory complications.
The primary objective is to demonstrate that induction of anesthesia using PEP + PSV, compared with induction of anesthesia under spontaneous ventilation, reduces the risk of adverse respiratory events in children requiring general anesthesia with planned inhalational induction.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Florent Baudin, Pr
- Telefoonnummer: +00334 72 12 97 35
- E-mail: florent.baudin@chu-lyon.fr
Studie Contact Back-up
- Naam: Clarisse Saunier
- Telefoonnummer: +0033427856264
- E-mail: clarisse.saunier@chu-lyon.fr
Studie Locaties
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Lyon, Frankrijk, 69677
- Hopital Femme Mere Enfant
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Contact:
- Florent Baudin, Pr
- Telefoonnummer: +00334 72 12 97 35
- E-mail: florent.baudin@chu-lyon.fr
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Contact:
- Eloise Cercueil, Dr
- Telefoonnummer: +00334 27 85 52 48
- E-mail: Eloise.cercueil@chu-lyon.fr
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Hoofdonderzoeker:
- Eloise Cercueil, Dr
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Marseille, Frankrijk, 13385
- Hôpitaux Universitaires de Marseille Timone
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Contact:
- Fabrice Michel, Dr
- Telefoonnummer: +334.91.96.47.58
- E-mail: fabrice.michel@ap-hm.fr
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Hoofdonderzoeker:
- Fabrice Michel, Dr
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Montpellier, Frankrijk, 34295
- Centre hospitalier universitaire de Montpellier
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Contact:
- Chrystelle SOLA, Dr
- Telefoonnummer: (+33)4 67 33 24 48
- E-mail: c-sola@chu-montpellier.fr
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Hoofdonderzoeker:
- Chrystelle SOLA, Dr
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Nantes, Frankrijk, 44000
- CHU de Nantes
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Contact:
- Jules LECOMTE, Dr
- Telefoonnummer: (+33) 2 40 08 32 50
- E-mail: jules.lecomte@chu-nantes.fr
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Hoofdonderzoeker:
- Jules Lecomte, Dr
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Paris, Frankrijk, 75019
- Hopital Robert Debre
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Contact:
- Souhayl DAHMANI, Dr
- Telefoonnummer: (+33)1 40 03 22 21
- E-mail: souhayl.dahmani@rdb.aphp.fr
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Hoofdonderzoeker:
- Souhayl DAHMANI, Dr
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Paris, Frankrijk, 75012
- Hôpital Armand Trousseau
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Contact:
- Mireille Nasr, Dr
- Telefoonnummer: +00331 44 73 51 20
- E-mail: mireille.nasr@aphp.fr
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Hoofdonderzoeker:
- Mireille Nasr, Dr
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Reims, Frankrijk, 51092
- Centre Hospitalier Universitaire de Reims
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Contact:
- Delphine Michelet, Dr
- Telefoonnummer: (+33)3 26 83 25 37
- E-mail: dmichelet@chu-reims.fr
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Hoofdonderzoeker:
- Delpine Michelet, Dr
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Strasbourg, Frankrijk, 67200
- Hôpital de Hautepierre
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Contact:
- Claire BOPP, Dr
- Telefoonnummer: (+33) 3 88 12 61 38
- E-mail: claire.bopp@chru-strasbourg.fr
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Hoofdonderzoeker:
- Claire BOPP, Dr
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Toulouse, Frankrijk, 31300
- CHU Toulouse - Hôpitaux des enfants
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Contact:
- Delhpine KERN, Dr
- Telefoonnummer: (+33)5 34 55 84 23
- E-mail: kern.d@chu-toulouse.fr
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Hoofdonderzoeker:
- Delhpine KERN, Dr
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Child between 3 months and 6 years old
- Without significant comorbidity (ASA 1 or 2)
- Admitted for elective or emergency/urgent surgery under general anesthesia
- With induction of anaesthesia by inhalation by sevoflurane on the machine circuit
- With airway control by intubation tube or supraglottic device
- Consent of at least one parent or legal guardian
Exclusion Criteria:
- Children with severe upper respiratory tract infection (severe moist cough, fever and lethargy, oxygen requirement) in the last 7 days requiring intravenous induction or postpone of the surgery
- Thoracic surgery with selective control of intubation
- Criteria for difficult intubation or known history of difficult intubation
- Children with a contraindication to sevoflurane (ex: risk of malignant hyperthermia)
- Children asking for intravenous induction or requiring rapid sequence induction
- Children with significant cardiac disease (pulmonary hypertension, cyanotic heart disease,…)
- Children not affiliated or beneficiary of a health insurance system
- Children participating in other interventional research with an exclusion period still in progress at inclusion
Exclusion Criteria :
- Failure of venous access after 30 min or more than 5 attempts
- Parents' consent withdrawal
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: PEEP + PSV
Induction with PEEP (5 cmH2O) and PSV (2-12 cmH2O)
|
Sevoflurane will initially be at 6% (with a fresh gas flow between 2L/min and 10L/min) or increase progressively according to local habits, which can be reduced between 4 and 6% during the installation of the vascular access and increased again to 6% before the control of the airway. The FiO2 will be set at 80% and can be increased up to 100% in case of desaturation. In the experimental group, the level of PEEP will be set at 5 cmH2O and inspiratory support between 2 and 12 cmH2O and adjusted by the anaesthetist in charge to optimize respiratory mechanics and obtain a physiological tidal volume of 8ml/kg. |
|
Ander: Induction in spontaneous breathing
|
Sevoflurane will initially be at 6% (with a fresh gas flow between 2L/min and 10L/min) or increase progressively according to local habits, which can be reduced between 4 and 6% during the installation of the vascular access and increased again to 6% before the control of the airway. The FiO2 will be set at 80% and can be increased up to 100% in case of desaturation. In the control group, there is no PEEP |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Number of respiratory adverse events among laryngospasm, bronchospasm, oxygen desaturation, airway obstruction and severe cough
Tijdsspanne: Day 0
|
|
Day 0
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Number of respiratory adverse events among laryngospasm, bronchospasm and oxygen desaturation < 90%.
Tijdsspanne: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Number of respiratory adverse events among airway obstruction, desaturation < 95% for more than 10s and severe cough
Tijdsspanne: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Use of oropharyngeal cannula or need for manual ventilation for difficult ventilation.
Tijdsspanne: Day 0
|
Risk difference and risk ratio at T4
|
Day 0
|
|
Number of attempts to control the airways
Tijdsspanne: Day 0
|
Attempts at tracheal intubation or laryngeal mask insertion, as reported by the physician in charge. Risk difference and risk ratio at T4 |
Day 0
|
|
Number of gastric distension requiring evacuation
Tijdsspanne: Day 0
|
Reported by the physician in charge.
Risk difference and risk ratio at T4
|
Day 0
|
|
Pressure support (cmH2O) and tidal volumes (ml/Kg)
Tijdsspanne: Day 0
|
Pressure support (cmH2O) set on the ventilator by the physician in charge (continuous variable) Tidal volumes measured on the ventilator by the physician in charge (continuous variable) Relation between the pressure support and the tidal volume at each time T1 and T2 separately |
Day 0
|
Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 69HCL24_0926
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